Seasonality, clinical characteristics, and outcomes of respiratory syncytial virus disease by subtype among children less than five years old, New Vaccine Surveillance Network, United States, 2016-2020.
Seasonality, clinical characteristics, and outcomes of respiratory syncytial virus disease by subtype among children less than five years old, New Vaccine Surveillance Network, United States, 2016-2020.
复制标题
五岁以下儿童呼吸道合胞病毒病按亚型的季节性、临床特征和结果，新疫苗监测网络，美国，2016-2020 年。
DOI：
10.1093/cid/ciae085
复制
发表时间：
2024
期刊：
影响因子：
--
通讯作者：
Selvarangan,Rangaraj
中科院分区：
文献类型：
--
作者：
Toepfer,ArianaP;Amarin,JustinZ;Spieker,AndrewJ;Stewart,LauraS;Staat,MaryAllen;Schlaudecker,ElizabethP;Weinberg,GeoffreyA;Szilagyi,PeterG;Englund,JanetA;Klein,EileenJ;Michaels,MarianG;Williams,JohnV;Selvarangan,Rangaraj
研究背景呼吸道合胞病毒（Respiratory syncytial virus，RSV）是引起儿童急性呼吸道疾病的主要病原. RSV可大致分为2种主要亚型：A和B。已知RSV亚型在世界不同地区存在变异性。在儿童中研究了与病毒亚型的临床相关性，结果相互矛盾，因此RSV亚型与严重程度之间没有确定的关系。MethodsDuring 2016-2020，在7个美国儿科医疗中心的急诊科或住院部，年龄<5岁的儿童参加了前瞻性监测。监测数据收集包括父母/监护人访谈、病历审查和收集中鼻甲鼻+/-咽喉拭子的RSV结果在6398例5岁以下RSV阳性儿童中，A亚型3424例（54%），B亚型2602例（41%），272例（5%）未分型、不确定或混合感染。在调整和未调整的分析中，RSV-A阳性儿童更有可能住院，以及限制在<1年。按季节，RSV-A和RSV-B cocirculated在不同的水平，1亚型占主导地位proportional.ConclusionsFindings表明，RSV-A和RSV-B可能只有轻微的临床区分，但这两种亚型与医疗照顾的疾病在儿童年龄<5岁。此外，RSV亚型的传播每年在季节和地理上都有很大变化。随着新的RSV预防产品的推出，这突出了持续监测RSV-A和RSV-B亚型的重要性。
BackgroundRespiratory syncytial virus (RSV) is a leading cause of acute respiratory illnesses in children. RSV can be broadly categorized into 2 major subtypes: A and B. RSV subtypes have been known to cocirculate with variability in different regions of the world. Clinical associations with viral subtype have been studied among children with conflicting findings such that no conclusive relationships between RSV subtype and severity have been established.MethodsDuring 2016–2020, children aged <5 years were enrolled in prospective surveillance in the emergency department or inpatient settings at 7 US pediatric medical centers. Surveillance data collection included parent/guardian interviews, chart reviews, and collection of midturbinate nasal plus/minus throat swabs for RSV (RSV-A, RSV-B, and untyped) using reverse transcription polymerase chain reaction.ResultsAmong 6398 RSV-positive children aged <5 years, 3424 (54%) had subtype RSV-A infections, 2602 (41%) had subtype RSV-B infections, and 272 (5%) were not typed, inconclusive, or mixed infections. In both adjusted and unadjusted analyses, RSV-A–positive children were more likely to be hospitalized, as well as when restricted to <1 year. By season, RSV-A and RSV-B cocirculated in varying levels, with 1 subtype dominating proportionally.ConclusionsFindings indicate that RSV-A and RSV-B may only be marginally clinically distinguishable, but both subtypes are associated with medically attended illness in children aged <5 years. Furthermore, circulation of RSV subtypes varies substantially each year, seasonally and geographically. With introduction of new RSV prevention products, this highlights the importance of continued monitoring of RSV-A and RSV-B subtypes.